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Sample Record for 2019-08-23-1

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: No Project QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-08-23-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 08/23/2019
Date that the sample was received by the laboratory/organization performing the testing: 08/28/2019
The quantity of what the sample constitutes: 3
A brief description of the sample: ASTM A563 DH 1.75" Plain
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS Lindon UT

Material Information

Rocap Number(s): NA
Heat Number(s): 188746
Nut Mfg. Lot Number(s): DEAJ
Washer Mfg. Lot Number(s): NA
Bolt Specification: NA
Bolt Length(s): NA
Nut Specification: ASTM A563 DH
Washer Specification: NA
Finish: Plain
Diameter/Size: 1.75"
Bolt Mfg. Lot Number: NA
Rocap Test Requirement(s): NA
Lubricant Requirements(s): Dry

Test Results

Test 1 of 5

DIME Test ID: 2019-08-23-1-1
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/04/2019
Date Tested: 09/03/2019
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAJ
Finish Coating Plain
Product Markings DH D/N 2H
Size 1.75 in
Gage Type Pass

Test 2 of 5

DIME Test ID: 2019-08-23-1-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/04/2019
Date Tested: 09/03/2019
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAJ
Finish Coating Plain
Product Markings DH D/N 2H
Size 1.75 in
Gage Type Pass

Test 3 of 5

DIME Test ID: 2019-08-23-1-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/04/2019
Date Tested: 09/03/2019
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAJ
Finish Coating Plain
Product Markings DH D/N 2H
Size 1.75 in
Gage Type Pass

Test 4 of 5

DIME Test ID: 2019-08-23-1-4
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/04/2019
Date Tested: 09/03/2019
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAJ
Finish Coating Plain
Product Markings DH D/N 2H
Size 1.75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 27.53
Spacing Ok

Test 5 of 5

DIME Test ID: 2019-08-23-1-5
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/04/2019
Date Tested: 09/03/2019
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAJ
Finish Coating Plain
Product Markings DH D/N 2H
Size 1.75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 28
Spacing Ok